Azzolini, V.

Cattel, Luigi

Francisco, C.

Gallicchio, Margherita

Marongiu, C.

Milla, Paola

English

Institutional Research Information System University of Turin

  Design of specific tools to evaluate the Cost Of Illness (COI) of Rheumatoid ArthritisC. Marongiu1, C. Francisco1, P. Milla2, M. Gallicchio2, L. Cattel2, V. Azzolini31Ivrea Hospital and School of Hospital Pharmacy - University of Torino, Italy.2School of Hospital Pharmacy, Dipartimento di Scienza e Tecnologia del Farmaco - University of Torino, Italy.3Ivrea Hospital - Rheumatology, Ivrea, Italy.Rheumatoid arthritis (RA) is an autoimmune disorder, affecting 1% of the population approximately. It is characterized bypain, joint swelling, progressive destruction of joint tissue. The patients not properly treated develop a progressivepermanent joint damage with serious disabilities, and have increased mortality compared with the general population. TheEuropean League Against Rheumatism recommends the use of Tumor Necrosis Factor alpha antagonists (anti-TNFα) incase of failure of methotrexate or others DMARDs (Disease Modifying Antirheumatic Drugs). Anti-TNFα agents (such asInfliximab, Adalimumab, Etanercept), in fact, were the first to be successfully used to induce remission or very low diseaseactivity in treating RA. However, the anti-TNFα therapies impose a significant economic burden on hospitals budgets andthey are in the top twenty most expensive drugs in Piedmont region.From a societal perspective is important not only the evaluation of cost of medicines, medical care and special devices(direct costs), but also the quantification of costs associated with the illness (COI) that consists in: indirect costs (mainlyfor the productivity losses) and intangible costs (those represented by the deterioration in the quality of life). In Italy, thereis a lack of data regarding the societal economic impact of RA after the introduction of anti-TNFα agents, and the aim ofour work is to set up specific tools to perform a pharmacoeconomic investigation in Piedmont region aimed to identify theCOI of RA. Afterward, the same tools should be exploited in order to perform a pharmacoeconomic investigation atnational level. We will analyze the payer's and societal perspective, investigating direct costs associated with health careutilization and indirect costs related to productivity loss.The specific tools consist of three questionnaires: 'Clinical Form', 'Patient Questionnaire', 'Patient Diary'.'Clinical Form' is filled in by the rheumatologists and consists of: patient's code, clinical history such as disease duration,disease activity index (DAS28; CDAI), HAQ score, ACR classification criteria, Sharp index, systemic manifestationsrelated to disease, pharmacologic treatments, prescribed anti-TNFα. The Clinical Form is repeated in: screening period,baseline period, follow up (on a quarterly basis).'Patient Questionnaire' is given by the rheumatologists to the patients and permits the collection of: demographic and socio-economic status of the patient (type of work), hospitalisation, day hospital admissions, specialist visits, laboratory tests anddiagnostic investigations, physical therapy sessions, drug therapies, the loss of working days or the loss of work, the loss ofworking days by relatives, caregivers services, domestic help, drug therapies, technical aids, travel expenses. The PatientQuestionnaire is repeated in: screening period, baseline period, follow up (on a quarterly basis).The 'Patient Diary' helps patients to record hospitalisations, specialist visits, therapies, costs due to the purchase oftechnical aids, costs due to informal care provided by caregivers.All the recorded data can be easily transferred to a database created ad-hoc and used to estimate direct and indirect costs ofRA. We expect that indirect costs will be higher than direct costs. Cost-effectiveness of an intervention depends on themaximum the decision makers are willing to pay for an extra unit of health effect, but it should be considered thattreatments with anti-TNFα, in a societal perspective, decrease health resources utilization and raise productivity.The specific tools that we have created will be used in a just started perspective, observational, multicentric, cost-effectiveness analysis of RA biological drugs, involving about 100 patients in Piedmont region.Powered by TCPDF (www.tcpdf.org)                               1 / 1

Design of specific tools to evaluate the Cost Of Illness (COI) of Rheumatoid Arthritis

https://iris.unito.it/bitstream/2318/151025/1/sif_cong36_poster.pdf

Design of specific tools to evaluate the Cost Of Illness (COI) of Rheumatoid Arthritis

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